What is a psychological evaluation?
When parents, teachers, or other individuals working with a child are concerned about delays in development, behavioral challenges, or learning they may be referred for a psychological evaluation. A psychological evaluation is a process that provides information to clarify if the child meets criteria for any diagnoses and ultimately can assist with developing a plan for treatment and intervention. By understanding a child’s strengths and weaknesses, parents, teachers, and other providers working with the child are better able to develop goals and determine how best to monitor progress. For children with autism spectrum disorder (ASD) they may participate in a psychological evaluation to determine if they meet criteria for the ASD but also to provide information about their intellectual or academic strengths and weaknesses, speech and language skills, and/or difficulties with behavior and executive functioning.
Typically, evaluations include several components. This is because decisions about whether a diagnosis is appropriate are best made by considering multiple sources of information rather than relying solely on the administration of a standardized test. The first component is often a review of any relevant medical records or previous evaluations as well as a detailed interview with parents, the child, and or any other relevant caregivers, teachers, or clinicians working with the child. After this, a child may participate in one-on-one standardized testing and the parents, caregivers, or teachers may complete behavioral questionnaires. The child is also observed throughout the evaluation process to provide more information.
Psychological evaluations take place in school and in outpatient medical settings such as hospitals and private behavioral health practices. The process is often similar across these settings, but will serve a different purpose. Outpatient evaluations result in medical diagnoses while educational evaluations determine eligibility for special education services.
What are standardized tests?
Standardized tests are tests that are administered, scored, and interpreted in a consistent and uniform way. Standardized tests provide norm-referenced scores that can be used to compare that individual’s performance to others. Some standardized tests are administered in a one-on-one setting as part of a psychological evaluation. When this is the case they are typically administered by a psychologist or other trained professional. In education settings, standardized tests are administered by a school psychologist to determine if a student is eligible for special education services. They may also be administered in a medical or clinical setting to determine if a child meets criteria for a diagnosis such as an intellectual or learning disability. There are several traits, characteristics, or abilities that may be examined using individually administered standardized tests.
- IQ –testing measuring cognitive and intellectual skills such as abstract thinking, problem solving, and reasoning
- Academic Achievement–testing measuring academic skills across reading, writing, and math
- Other Neuropsychological Measures – specialized testing focused on specific aspects of neurocognitive functioning such as memory, visual processing, or executive functioning skills
Students also frequently participate in group administered standardized tests. In many cases, group administered standardized tests are required by a child’s school or state. These tests are often used to determine whether students are meeting certain academic benchmarks in their learning and to monitor their progress throughout the school year. Additionally, students may choose to participate in group administered college entrance exams such as the SAT or ACT to be reported as part of the application process. Group administered standardized tests typically use simplified directions and administration procedures, and as a result are not modified typically. However, students may receive accommodations such as extra time or testing in a smaller group with less distractions.
What are the barriers to success in individualized standardized testing for students with ASD?
There are certain characteristics of autism spectrum disorder that may impact performance during standardized testing.
- Language Deficits. Some individuals on the autism spectrum may display delayed speech and language skills. Verbal language proficiency should always be considered when completing standardized testing as this may impact understanding of directions as well as an individual’s ability to explain what they know. Pragmatic language difficulties such as difficulty understanding idioms or sarcasm should also be taken into consideration. In some cases, nonverbal measures that have a reduced verbal language demand may be appropriate.
- Joint Attention Deficits. Joint attention is the ability for an individual to share interest in an object or event with someone else. During standardized testing, a student will need to look at manipulatives, pictures, or other activities when asked to do so or else they may not understand the task. Individuals with ASD often have delayed joint attention and therefore this may impact their performance.
- Behavioral Difficulties. Individuals on the autism spectrum may be at increased risk to engage in disruptive behaviors. In particular, during testing this may happen if tasks are difficult, or cause stress or anxiety. A child that struggles to follow verbal instructions or engages in stereotyped or repetitive behaviors may also have a hard time participating in standardized testing and be more likely to engage in off-task behaviors that impair their ability to complete activities to the best of their ability.
- Sustained Attention. Individuals on the autism spectrum are more likely to struggle with maintaining their attention, in particular during activities that are not of interest to them. This can impact performance, especially during tests that have a time limit.
What modifications can psychologists make
to accommodate students with ASD?
Despite some of these barriers, psychologists conducting standardized testing with individuals on the autism spectrum may need to make some adjustments to support improved outcomes. While standardized testing often requires certain structured procedures, individuals working with those on the spectrum may need to break some standardized procedures to better accommodate the needs of the individual.
|Type of Modification||Description of Modification|
|Allow time for rapport building||Prior to beginning of testing, spend time asking the student about their interests, engaging in a preferred activity, and/or explaining the schedule for the day to build trust and ease anxiety.|
|Use of nonverbal measures when appropriate||Some intelligence tests and neuropsychological measures are available in a nonverbal format that reduces the need for verbal language skills to complete the assessment.|
|Adjust the environment||Special care to limit distractions in the environment may be helpful in addition to access to preferred seating or fidget toys that may help a child with sensory processing differences.|
|Use a visual schedule||Use of a visual schedule that shows the child how many activities they will need to complete during the testing session and allows the child to see how many activities are left before the testing will be complete.|
|Increased positive reinforcement||Access to stickers, snacks, or brief breaks with access to a preferred activity can be used as positive reinforcement throughout the testing session to increase motivation and increase attention to task.|
|Special attention to observation, multiple sources|
of information, etc.
|When it is possible that results from standardized testing may be influenced by symptoms of ASD, the psychologist will benefit from careful observation and collecting information from multiple sources whenever possible (e.g. parents, teachers, and other providers).|
Merrill, A. (2019). Psychological evaluation and autism spectrum disorder: Considerations for standardized testing. Retrieved from Psychological evaluation and autism spectrum disorder: Considerations for standardized testing.